Quadir Nazia, Deopujari Rashmi, Agrawal Ranjana, Kudopa Ashwini, Chourasia Rajveer Singh
Department of Anatomy, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
Department of Anatomy, Atal Bihari Vajpayee Medical College, Madhya Pradesh, India.
J Pharm Bioallied Sci. 2025 Jun;17(Suppl 2):S1755-S1757. doi: 10.4103/jpbs.jpbs_322_25. Epub 2025 Jun 18.
The ulnar artery, the larger terminal branch of the brachial artery, is a key contributor to forearm vascularization. It traverses the Guyon's canal alongside the ulnar nerve in the palmar medial carpal region. Due to its favorable anatomical properties, the ulnar artery has gained significance as an alternative to the radial artery for coronary angiography and angioplasty. Additionally, the ulnar artery forearm flap is widely used in reconstructive head and neck surgeries and post-burn contracture management. Variations in the course and branching pattern of the ulnar artery in the medial carpal region are clinically significant for surgical interventions.
The study was conducted on 50 formalin-fixed cadaveric upper limbs obtained from the Department of Anatomy, P.C.M.S. and R.C, Gandhi Medical College, and Chirayu Medical College. Dissection was performed in the medial palmar carpal region to examine the course, tortuosity, and branching pattern of the ulnar artery. The boundaries of the Guyon's canal were delineated, and any variations in the artery's trajectory and termination were recorded. Digital photographs documented the anatomical findings.
In all but one case, the ulnar artery was found to traverse through the Guyon's canal. A tortuous course was observed in 38% of cases, while 62% exhibited a straight trajectory. The tortuosity extended 6 cm proximally and 4 cm distally from the pisiform bone and resulted in ulnar nerve kinking in 16% of cases. The deep terminal branch originated distal to the pisiform in 94%, at its level in 4%, and proximal to the pisiform in 2% of cases. The artery was accompanied by venae comitantes and gave rise to dorsal cutaneous, dorsal carpal, and palmar carpal branches. A unique case was noted where the deep branch traversed deep to the flexor retinaculum and gave off a superficial branch entering the palm.
This study highlights the variability in the ulnar artery's course, with a 38% prevalence of tortuosity and its potential impact on clinical procedures. The findings are crucial for vascular surgeons and interventional cardiologists, especially when performing transulnar angiography and angioplasty. Additionally, understanding the branching pattern enhances precision in reconstructive microsurgery and prevents inadvertent nerve compression or ischemic complications.
尺动脉是肱动脉较大的终末分支，是前臂血管形成的关键贡献者。它在手掌内侧腕部区域与尺神经一起穿过Guyon管。由于其有利的解剖学特性，尺动脉作为冠状动脉造影和血管成形术桡动脉的替代物已变得重要。此外，尺动脉前臂皮瓣广泛用于头颈部重建手术和烧伤后挛缩的处理。腕部内侧区域尺动脉走行和分支模式的变异对手术干预具有临床意义。
本研究对从甘地医学院解剖学系、奇拉尤医学院获得的50例福尔马林固定的尸体上肢进行。在手掌内侧腕部区域进行解剖，以检查尺动脉的走行、弯曲度和分支模式。划定Guyon管的边界，并记录动脉走行和终末的任何变异。数码照片记录解剖学发现。
除1例病例外，所有病例中尺动脉均穿过Guyon管。38%的病例观察到弯曲走行，而62%表现为直线走行。弯曲度从豌豆骨向近端延伸6cm，向远端延伸4cm，16%的病例导致尺神经扭结。94%的病例中深终末支起源于豌豆骨远端，4%在其水平，2%在豌豆骨近端。动脉有伴行静脉，并发出手背皮支、腕背支和腕掌支。注意到1例独特病例，深支穿过屈肌支持带深部并发出1支浅支进入手掌。
本研究突出了尺动脉走行的变异性，弯曲度发生率为38%及其对临床操作的潜在影响。这些发现对血管外科医生和介入心脏病学家至关重要，尤其是在进行经尺动脉血管造影和血管成形术时。此外，了解分支模式可提高显微重建手术的精确性，并防止意外的神经压迫或缺血性并发症。
